Thursday, May 23, 2013

Some State Exchanges Are Now Sifting Through Carrier Applications

Reprinted from INSIDE HEALTH INSURANCE EXCHANGES, a hard-hitting newsletter with news and strategic insights on the development and operation of federal, state and private exchanges.
By Steve Davis, Managing Editor
May 16, 2013 Volume 3 Issue 8
May 3 was the application deadline for submitting applications to sell coverage through federally facilitated exchanges. A CMS spokesperson declined to tell HEX how carriers have people applied. Late last month, Gary Cohen, director of the Center for Consumer Information and Insurance Oversight (CCIIO), estimated that 140 carriers had started the application process, according to a Politico blog. It’s unclear how CCIIO is counting those applicants. National carriers, for example, might be counted for each state where they intend to sell coverage.
State exchanges tell HEX that national and state-based carriers, as well as Medicaid managed care companies and Consumer Operated and Oriented Plans (CO-OPs), have submitted applications. The plan-submission deadline for several state exchanges has passed, although a few have deadlines as late as June 30. Here’s an overview of applications and letters of intent that carriers have submitted to state exchanges so far:
·         California: Covered California accepted bids from carriers until April 8. A spokesperson for the exchange tells HEX that 33 carriers have expressed interest in participating, but she declines to disclose how many bids were received or say which carriers submitted bids.
·         District of Columbia: A spokesperson for Washington, D.C.’s exchange says it has received letters of intent from the region’s four major carriers now selling in the individual and small-group markets — CareFirst BlueCross BlueShield, Kaiser Permanente, Aetna Inc. and UnitedHealth Group. So far, Medicaid managed care companies have not applied to sell a commercial product in the exchange, according to spokesperson Richard Sorian.
·         New Mexico: Legislation to create the state’s insurance exchange was approved by state lawmakers in mid-March. Its recently assembled board held its first meeting early this month. One of its biggest challenges will be choosing a contractor to create the IT infrastructure. Problems with the submission software prompted the exchange to extend the April 30 deadline until it was fixed. One issue is that carriers submitted applications in several formats. Six carriers — including one Medicaid managed care company — have submitted applications to sell coverage through the exchange. All of the applicants already sell coverage in the state. While the names have not yet been made public, spokesperson Lisa Reid confirms that they are all “major players” in the New Mexico market. The exchange is being operated through the New Mexico Health Insurance Alliance, a nonprofit public corporation that provides access to insurance for small businesses and individuals. The state expects 200,000 people to purchase insurance through the exchange. About 21% of the state’s population is uninsured.
·         Utah: In a unique arrangement, HHS has agreed to run Utah’s individual insurance exchange, while the state will continue to operate the small-group marketplace (see Federal Reg Tracker, p. 5). Under an arrangement approved May 10, the state will operate the Small Business Health Options Program (SHOP) portion of the exchange — Avenue H. The exchange will not be responsible for determining Medicaid eligibility or calculating federal premium subsidies for applicants in the individual marketplace. But Utah’s exchange will conduct plan management for both small-group and individual products, says Avenue H Director Patty Conner. Three carriers — Regence BlueCross BlueShield, SelectHealth and UnitedHealth Group — already participate in the state’s small-employer marketplace. Arches Health Plan, a CO-OP, will be participating in both marketplaces in 2014 per requirements of its approval (see table, p. 6). She tells HEX that carriers have been engaged in the process and are completing the templates, but says no complete applications have been submitted. Carriers must submit applications by May 31.
·         Washington state: Nine carriers submitted letters of intent to collectively offer 57 qualified health plans in the individual market, and five carriers expressed interest in selling through the SHOP exchange. At least two Medicaid managed care companies — Centene Corp. and Molina Healthcare, Inc. — submitted letters of intent to sell a commercial product on the individual market. Asuris Northwest Health, BridgeSpan Health, Community Health Plan of Washington, Kaiser Permanente and Regence BlueCross BlueShield of Oregon submitted letters of intent to sell coverage in both the individual market and the SHOP. Asuris and Regence are subsidiaries of Cambia Health Solutions. Five stand-alone dental carriers have also submitted letters of intent.
http://aishealth.com/archive/nhex051613-03

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